| NPI | 1235651209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN FITZPATRICK Credentialing 774-345-4130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00384700) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2020-08-19 |